Is There Finally A Treatment For Dry Macular Degeneration? By Dr Rupal Morjaria, Consultant Ophthalmologist

For many people diagnosed with dry macular degeneration, one of the first questions is:

“Is there anything that can actually be done to improve my vision?”

Historically, treatment options for dry age related macular degeneration have been limited. Much of the focus has been on monitoring the condition, reducing risk factors and slowing its progression rather than improving the function of the retina itself.

However, an emerging treatment called photobiomodulation (PBM), more commonly described as red light therapy, could begin to change this.

Recent research has shown encouraging 2 year results with intermediate dry macular degeneration, looking at reading speed, visual acuity and change in scan appearance.

As a Consultant Ophthalmologist and Medical Retina Specialist, this is an exciting development in an area of retinal medicine where treatment options have traditionally been limited.

The short answer

Yes, there is promising evidence that red light therapy may help certain people with dry age related macular degeneration (AMD).

A major clinical study called LIGHTSITE III investigated photobiomodulation using the Valeda Light Delivery System in people with intermediate dry AMD.

The latest results found improvements in vision in many of the eyes receiving treatment. The study also found encouraging evidence that fewer treated eyes progressed to geographic atrophy, an advanced form of dry AMD.

Importantly, the treatment demonstrated a favourable safety profile during the study, with no signs of light induced retinal damage.

This does not mean red light therapy is a cure for macular degeneration or that it is suitable for everybody. However, it represents an important and promising development for people living with dry AMD.

What is dry macular degeneration?

Age related macular degeneration affects the macula, the small central area of the retina responsible for our detailed central vision.

It is the part of your vision that helps you read, recognise faces, drive and see fine detail.

There are two main forms of AMD: wet AMD and dry AMD.

Wet AMD involves abnormal blood vessels developing beneath the retina and can be treated with injections into the eye.

Dry AMD is different. It usually develops more gradually as cells within the macula become damaged over time.

In its advanced form, dry AMD can develop into geographic atrophy, where areas of the retina progressively lose functioning cells. This can eventually have a significant effect on central vision.

Until recently, there have been relatively few options for people with dry AMD.

What is red light therapy for macular degeneration?

The medical term is photobiomodulation (PBM).

Although it is often referred to as red light therapy, this is not the same as using a red lamp or an ordinary light therapy device at home.

The treatment uses carefully controlled wavelengths of light delivered to the eye using specialist medical equipment.

One system developed specifically for this purpose is the Valeda Light Delivery System, which was used in the LIGHTSITE III clinical trial.

The treatment itself is non invasive. It does not involve an injection into the eye or an operation.

Instead, particular wavelengths of light are directed towards the retina during a series of treatment sessions.

How could red light therapy help the retina?

To understand the idea behind the treatment, it helps to think about how retinal cells obtain their energy.

Inside our cells are tiny structures called mitochondria. Their job is essentially to help produce the energy that cells need to function.

The retina is one of the most metabolically active tissues in the body, meaning its cells require considerable energy.

As we age, the processes responsible for producing and regulating this energy can become less efficient. Mitochondrial dysfunction and oxidative stress are among several processes believed to contribute to retinal degeneration.

Photobiomodulation uses specific wavelengths of light that are thought to stimulate cellular activity within the retina.

In simple terms, the aim is to help stressed retinal cells produce and use energy more effectively, potentially supporting their function and resilience.

This is why there is growing interest in whether photobiomodulation could do more than simply manage risk factors and may have a direct effect on retinal function.

What could patients do for dry AMD before red light therapy?

Before photobiomodulation, management of dry AMD largely concentrated on monitoring the retina and reducing the risk of further progression.

The Age Related Eye Disease Studies (AREDS and AREDS2) established that a particular combination of vitamins and minerals can reduce the risk of progression from intermediate to advanced AMD in appropriate patients.

These supplements do not cure AMD and they do not restore retinal damage. Lifestyle remains important.

Stopping smoking is particularly significant because smoking is one of the strongest modifiable risk factors for AMD.

A balanced diet containing plenty of vegetables, particularly leafy green vegetables, and appropriate sources of healthy fats such as oily fish can also form part of looking after your wider retinal and cardiovascular health.

The important distinction is that these approaches have largely focused on reducing risk and slowing progression.

Photobiomodulation is particularly interesting because research is now investigating whether treatment can directly support retinal function and provide measurable visual benefits in some patients.

Who could be suitable for red light therapy?

This is an important question because not everybody with macular degeneration will necessarily be suitable.

LIGHTSITE III primarily investigated people with intermediate dry AMD.

Before considering treatment, the retina therefore needs to be assessed carefully to determine the type and stage of macular degeneration present.

Optical Coherence Tomography (OCT) allows us to examine the individual layers of the retina in considerable detail.

This can help distinguish intermediate dry AMD from advanced geographic atrophy, wet AMD and other retinal conditions that may require a completely different treatment approach.

Your vision, retinal appearance, symptoms and wider eye health all need to be considered together.

The important first step is therefore not simply asking whether red light therapy works.

It is establishing whether your particular eyes are likely to be suitable for it.

Can red light therapy reverse macular degeneration?

At present, I would not describe photobiomodulation as a cure or say that it reverses macular degeneration.

Once retinal cells have been permanently lost, treatment cannot simply recreate them.

What makes the emerging evidence interesting is that some patients experienced measurable improvements in visual function, while the study also identified changes suggesting a potential effect on disease progression.

This is an important distinction.

The aim is not to promise that damaged eyesight will return to normal. It is to explore whether supporting the remaining retinal cells could help patients make better use of the vision they still have and potentially protect retinal function for longer.

Why specialist assessment matters

Macular degeneration can vary considerably from one person to another.

Two patients who have both been told they have “dry AMD” may have different retinal appearances, different levels of vision and different stages of disease.

As a Consultant Ophthalmologist and Medical Retina Specialist, I assess the retina alongside your symptoms, vision and detailed retinal imaging to establish what type of macular degeneration is present and what options may be appropriate.

With emerging treatments such as photobiomodulation, selecting the right patient is particularly important.

The bottom line

Red light therapy, medically known as photobiomodulation, is an emerging treatment for dry age related macular degeneration.

This does not mean that red light therapy is a cure, nor will every patient experience the same improvement.

However, for a condition where treatment options have historically been limited, the results represent a promising development.

Ultimately, the most useful question may not simply be:

“Does red light therapy work for macular degeneration?”

But:

“Could red light therapy be suitable for my type and stage of macular degeneration?”

Ready to take the next step?

If you have dry macular degeneration and would like to understand whether photobiomodulation may be appropriate for your eyes, a specialist retinal assessment can help establish the type and stage of your condition.

Following a detailed assessment, I can explain your retinal findings, discuss the evidence behind treatment and advise you on the options most appropriate for your individual eyes.

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